264 e-Letters

published between 2008 and 2011

  • Deaths are not always what they seem
    Peter Sidebotham

    The child death review procedures in place in England (1) are ideally placed to address the issues that Kenny and Martin raise in their paper on drowning and sudden cardiac death (2). Although rare - there were 43 drowning deaths of 0-19 year olds in England in 2009 (3), such deaths may hide important medical conditions, notably cardiac rhythm disorders.

    Following every unexpected child death, a rapid response...

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  • Neonatal Trials in the UK: additional information from the Bracelet Study
    Diana R Elbourne

    Modi and McIntosh [1] discuss over-regulation of clinical trials and the small number of large neonatal multicentre trials carried out in the UK in 2006.

    As there is no single and exhaustive repository of data about UK trials, it is difficult to determine exactly the level of trial activity at that time. We can provide data which include 2006 from a survey of level 2 and 3 neonatal units which identified ran...

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  • When are paediatricians negligent?
    Kenneth N Wilkinson

    Harvey Marcovitch suggests that it is "good news" that only 4% of cases are settled in court. Nearly half (43%) are settled out of court. Is this because in these cases it is not clear to either party whether there has been negligence or not; or is it because medical attendants have simply performed below average? At any one time half of us, by definition, will perform below average. A settlement out of court, to many p...

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  • Procedural sedation for paediatric neuroimaging: time to move on!
    Piet L Leroy

    In their observational study Sammons et al. showed that general anaesthesia (GA) is more convenient and better tolerated than procedural sedation (PS) for paediatric neuroimaging.1 These findings are fully consistent with what can be obviously concluded from recent literature: in paediatric neuroimaging, and especially in magnetic resonance imaging, standard sedatives lack optimal effectiveness. The obvious explanation is...

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  • Response to "Food as a source of outbreaks of group A streptococcal disease"
    Kenneth H Lamden


    Eisenhut raises the possibility that food was the source of the outbreak of group A streptococcal disease at the primary school. This hypothesis was considered, but was rejected as implausible for several reasons; firstly the outbreak was not a true point source as it was preceded by five sentinel cases over a 12 day period, in addition the peak on the 16th May was inflated as it included cases with on...

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  • Do early versus late presentations make a difference?
    Mitch Blair

    Manzano et al present data from a tertiary hospital ER department and claim that the blood markers are superior to the clinical evaluation. What is not clear from the data presented is whether there are differences between them in relation to early or later presentation of illness in this setting. We have published data previously on the use of procalcitonin in a similar age group suggesting that this is superior in identif...

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  • Is "parental concern" the view of the mother, the father or both?
    Inger Brännström
    I am interesting in the field on how child health research and researchers make attention to gender recognition in:(a) their exposed research methodology and (b) in health interventions, thus, preventive recommendations regarding child health matters. Therefore, I have recently (2010) published one article concerning the study field "Sudden Infant Death Syndrome" (SIDS) by scrutinizing informatics focusing on gender and sleeping...
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  • Non-pharmacological analgesia - effective but underused
    Abdul Q. ismail

    Dear Sir,

    Losacco et al's1 review of practice across European neonatal units regarding the use of non-pharmacological analgesia for painful procedures in neonatal units has highlighted the relatively infrequent use of these techniques. This is despite good evidence confirming the effectiveness of non-pharmocolgical analgesia2 and evidence of deleterious effects of pain on babies both in short term3 (decreased o...

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  • Vaccination as an important example
    Peter M English
    Woolley's excellent article covers the subject well. One area where the issue of consent arises fairly frequently is that of vaccination. Although the science is clear that (with a few exceptions for contraindications), vaccination according to the recommendations of the Joint Committee on Vaccination and Immunisation (JCVI) and the "Green Book",[1] is generally in the child's best medical interests.

    Some parents, ho...
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  • Prevalence of anemia in children with thromboembolism in IBD
    Matteo Bramuzzo

    Dear Editors, we read with interest the article by Munot et colleagues1 regarding the possible causative role of anaemia in the pathogenesis of stroke in children. Several studies suggest an increased risk of venous and arterial thromboembolism in adults with inflammatory bowel disease (IBD) compared to the general population2. We recently performed a systematic review of studies on incidence and characteristic of throm...

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